Individual
SENORA WOODARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2316 ANGIER RD, FUQUAY VARINA, NC 27526
(919) 639-6893
(919) 639-2913
Mailing address
2316 ANGIER RD, FUQUAY VARINA, NC 27526
(919) 639-6893
(919) 639-2913
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL092231
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803171
—
NC
Enumeration date
01/25/2007
Last updated
01/03/2008
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